The impact of children’s cleft palate repair on maxillofacial morphological growth
10.3760/cma.j.cn114453-20220415-00117
- VernacularTitle:儿童腭裂修复术后颌面形态发育的观察研究
- Author:
Cheng FANG
1
;
Dongyi LAN
;
Chunyuan ZHANGSONG
;
Chenbin DONG
Author Information
1. 复旦大学附属儿科医院整形外科，上海 201102
- Keywords:
Cleft palate;
Child;
X-ray cephalometry;
Three-dimensional scanning;
Maxillofacial development
- From:
Chinese Journal of Plastic Surgery
2023;39(7):711-720
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the maxillofacial morphological development of children with different types of cleft palate after cleft palate repair.Methods:The clinical data of children who underwent cleft palate repair in the Department of Plastic Surgery, Children’s Hospital of Fudan University from January 2015 to December 2020 and normal children during the same period were retrospectively analyzed. All the included children were treated by the same physician at 8 to 18 months of age with loose incision and Langenbeck repair for cleft palate. X-ray cephalometric data and facial three-dimensional scanning data were obtained from the maxillofacial database of the Plastic Surgery Department of the hospital. According to the type and age of cleft palate, the children with cleft palate were divided into 6 groups: Group 1, 8 months to 1 years old children with grade Ⅰ cleft palate before operation; Group 2, 8 months to 1 year old children with grade Ⅱ-Ⅲ cleft palate before operation; Group 3, 2-3 years old children with grade Ⅰ cleft palate after operation; Group 4, 2-3 years old children with grade Ⅱ-Ⅲ cleft palate after operation; Group 5, 4-6 years old children with grade Ⅰ cleft palate after surgery; Group 6, 4-6 years old children with grade Ⅱ-Ⅲ cleft palate after operation. According to age, normal children were divided into three groups: Group 7, 8 months to 1 year old normal children; Group 8, 2-3 years old normal children; Group 9, 4-6 years old normal children. Analysis of variance was used to compare the measurement data of normal distribution between groups. Dunnett- t test was used to compare the maxillofacial features of children with grade Ⅰ cleft palate and grade Ⅱ-Ⅲ cleft palate with normal children of the same age. Results:A total of 183 children with cleft palate were included, including 84 females and 99 males, aged (3.6±2.1) years. There were 302 normal children, including 114 females and 188 males, aged (4.1±1.9) years. Groups 1 to 9 included 23, 46, 19, 37, 23, 35, 83, 105 and 114 children, respectively. The analysis result showed that the horizontal length, vertical height and angle of maxillary and mandibular were not significantly different from that of normal children of the same age in the preoperative cephalometric and three-dimensional scanning result of the children with grade Ⅰ and Ⅱ-Ⅲ cleft palate. However, the horizontal length, vertical height and angle of maxillary and mandibular were significantly different from that of normal children of the same age at 2-3 years and 4-6 years after surgery. Moreover, the difference between maxillofacial characteristics of children with grade Ⅱ-Ⅲ cleft palate and normal children of the same age is more significant than that of children with grade Ⅰ cleft palate.Conclusion:Maxillofacial morphological development is inhibited at different ages in children with different types of cleft palate after repair, which is manifested as the backward development of maxillofacial horizontal length, vertical height and angle of maxillary and mandible. Moreover, the maxillofacial morphological development inhibition was more serious in children with grade Ⅱ-Ⅲ cleft palate than in children with grade Ⅰ cleft palate.
